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University of Toronto Scarborough
Health Studies
Anna Walsh

HLTB01H3Y: Health, Aging and the Life Cycle Department of Health Studies University of Toronto at Scarborough Summer 2010 Instructor: Anna Walsh. Term: Summer 2010 Mondays 10 a.m.-12 p.m. Lecture Room: SW 319. July 52010. A&G: Ch 9 - The Interface Between Physical and Mental Health. Stress and Mental Health. A&G: Ch 10 - Stress, Coping, and Health. Chapter 9 The Interface between Physical and Mental Health Personality Processes and Disease N The idea that personality characteristics are related to health and illness is not new, by any means. N Hippocrates: o Substances called humors influenced personality and health Blood: ruddy, sanguine personality Melancholy (black bile): excess > prone to depression and degenerative disease Choler (yellow bile): too much > angry and bitter Phlegm: cause apathy N Descartes: mind and body were separate and only connected through the pineal gland N Sigmund Freud is credited with developing the first Western scientific theory of mind, and he believed that eventually psychological phenomena would be traced back to neurophysiological events. o Many of the studies done in the past had no controls or compared people with pre-existing illnesses to healthy controls N Many people also blamed the psychosomatic illnesses on the victim and said it was all in their heads o However, health psychology and behavioural medicine state that the mind and the body are connected in a transactional manner Bidirectional: reciprocal relationship between physical and psychological health N More recent research has reinstated the relationship between personality and disease outcomes. Psychological Risk Factors and Health Hostility N Type A personalityType A Behaviour Pattern (TABP) o Friedman and Rosenman > noted that chairs of patients worn at the ends because they sat at the edges 1 www.notesolution.com Dinctinctive characteristics include: extreme and eaily aroused hostility, achievement motivation, time urgency, explosive speech patterns o Two ways of assessing this personality type: Structured interview: express hostility in standardized ways, get annoyed by slow people and finish their sentences, angry when challenged Self report questionnaires (ex. Jenkins activity survey): did not predict heart disease well and they found that the hostility component was the best predictor of CHD o Relation to Coronary heart disease (CHD) Higher in hostility = more likely to develop it and have higher rates of overall mortality Structured interview provides more consistent results of having this Relationship between hostility and CHD is stronger for men, young people After age 56, Type Bs were higher in it probably due to survivor effects High in hostility tend to be low in social support = higher risk for CHD o More likely to have poor healthy behaviour: likely to smoke, drink excessively, weigh more, be less active N Hostility levels are highest in adolescence N May be protective in late life because negative behaviour produces more attention from nurses and dismisses feelings of helplessness Anxiety N Relatively consistent effects of anxiety on heart disease and overall mortality have been found. N High in anxiety = 4.5 times the risk for sudden cardiac death, phobics = 6 times the risk for sudden cardiac death N Releases catecholamines which stimulates the heart rate N Heart disease = loss of control of normal autonomic nervous system = decrease in parasympathetic control = heart vulnerable to stimulation via catecholamines N Heart rate variability decreases with age but marked among those with diabetic neuropathy and vascular disease Depression N Perhaps the strongest association between negative affect and health in late life is found with depression. N Widowed men more likely to die of CHD after first year of bereavement > risk decreasing after 1 year N Relationship between bereavement and mortality stronger among middle aged than older adults N Depressive symptoms were unstable > those found depressed at one point not necessarily depressed when assessed later N High levels of depression = 1.5 2 times more at risk to develop CHD N Depressed individuals were 4 times as likely to die than those with a myocardial infarction because depression was a stronger predictor of mortality N More likely to be smokers, have poor diet, less likely to exercise N Loss of appetite = classic symptom of depression N Linked to atherogenesis, arrhythmias, sudden death 2 www.notesolution.com
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